Healthfirst NY Exchange. WTF

Thinking of changing to them from Fidelis which sucks. Trying to find out what my co-pay would be for Botox, which is not listed under their formulary and would only be approved when the doctor writes a letter of medical necessity after eight calls in four hours no one can tell me what the co-pay of this medication would be under one of the plans I’m looking at Member services says they can’t talk to you because you’re not a member I’ve spoken to acquisition team who should be selling used cars and I’m sure work on commission because they only want to sign you up. I’ve spoken to CVS who handles their pharmacy benefits, and the specialty pharmacy who I have used. What they are basically telling me is I need to become a member sign up, have the Dr. submit letter of medical necessity, get it approved, then have the pharmacy submit a claim to see what the copay would be. If I don’t like it I have 30 days to cancel my plan and go back to fidelis.

This is total insanity.

This is total insanity. There has to be a better away.

submitted by /u/Remarkable-World-234
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